Interest in the genital integrity issue
continues to grow and trustworthy statistics are necessary
for an informed debate. The American Academy of Pediatrics
complained that statistics being cited are outdated and
inaccurate.1 The goal of this
paper is to provide recent, accurate and consistent
statistics for that discussion. This white paper addresses
United States neonatal male circumcisions performed in
hospitals.

Source Data: According to the U.S. Census Bureau the most accurate
figures for live births is the National
Center for Health Statistics (NCHS).2 Live births and male births from
1990-2001 are from the annual NCHS reports including the
recent Births: Final Data for 2000 (100% samplings). The
NCHS tracks the sex ratio; in recent years it has been 1047
males for every 1000 females born live, or 51.15%.3 This figure has changed little in
the past 50 years and is used to calculate male births for
years 1990-1997. The number of circumcisions is from health
care analysts Solucient who compiled an Inpatient
View report (33% samplings) on annual male4 neonate5 circumcisions6 performed in hospitals between 1990
and 2001.

The only known historical compilation of
circumcision rates is in Edward Wallerstein’s
Circumcision: An American Health Fallacy.7 His statistics are estimates for the
years 1870 (the year circumcision was introduced to the
United States8) through 1979. In
1979 popularity of circumcision reached a record high in the
United States at 85%. Since then the rate has been
decreasing. In comparison, the United Kingdom’s
circumcision rate is 0.41% for one-year-olds.9

Year

Circumcisions

%
Change

Live
Births

Male
Births

%
Intact

%
Circumcised

2001

1,137,654

-6.3%

4,040,121

2066522*

44.9%

55.1%

2000

1,214,312

1.9%

4,058,814

2076969

41.5%

58.5%

1999

1,191,733

-1.1%

N/A

2,026,854

41.2%

58.8%

1998

1,204,431

+5.0%

N/A

2,106,205

42.8%

57.2%

1997

1,146,839

-12.9%

3,880,894

1,985,077

42.2%

57.8%

1996

1,317,422

+9.5%

3,891,494

1,990,499

33.8%

66.2%

1995

1,203,223

-3.0%

3,899,589

1,994,640

39.7%

60.3%

1994

1,240,572

-1.3%

3,952,767

2,021,840

38.6%

61.4%

1993

1,257,461

-5.8%

4,000,240

2,046,123

38.5%

61.5%

1992

1,334,742

+0.9%

4,065,014

2,079,255

35.8%

64.2%

1991

1,323,189

-2.6%

4,110,907

2,102,729

37.1%

62.9%

1990

1,358,218

N/A

4,158,212

2,126,925

36.1%

63.9%

The intact rate for 2001 is 44.9%.10 The last time the rate was this high
was around 1930, 64 years ago. In 1979 an estimated 15% of
boys retained their normal penis.11 The intact rate has increased almost
three-fold since then. The number of circumcisions in 2001
decreased 6.3% from the previous year.

Neonatal circumcisions account for 99.3% of
U.S. circumcisions. It is the most often performed surgery in
the U.S.A.12 Hospital
circumcisions account for an estimated 99% of U.S.
circumcisions.13

Circumcision in the neonatal period is
contraindicated.14 The American
Academy of Pediatricians concluded: “There is no
absolute medical indication for routine circumcision of the
newborn.” 15 The American
Medical Association concurs.16

There are conflicting reports of the true
cost of neonatal circumcisions. Medicaid paid at least $35
million for circumcision in 1999.17 The AAP estimates that circumcision
costs $150-270 million annually.18 The additional cost of complications
and extra hospital stay (averages ½ day) has not been
estimated.

Deaths from circumcision and related causes
are estimated at 229 per year.19

The number of circumcisions varies by
region.20 Over the past ten
years numbers in the Northeast and North Central regions have
dropped while those in the South region have risen, while
circumcisions in the West have remained about the same.

Racial make-up of patients changed over the
past ten years. The number of circumcisions to White infants
is down 38%. Black circumcisions are down 34%. Asian
circumcisions are up 30%. American Indian circumcisions are
up 263% and Hispanic circumcisions are down 21%.21

No female circumcision has been performed in
U.S. hospitals since 1991 when 8 surgeries were performed. It
is illegal to circumcise females in the U.S. except for
diagnosed medical conditions.22

This report will be updated annually as data
becomes available. Dan Bollinger is an independent
men’s studies researcher and instructor for men’s
workshops. He resides in West Lafayette, Indiana. danbollinger@insightbb.com